Spectral-Domain Optical Coherence Tomography Imaging in Peripheral Ulcerative Keratitis. A Corneal Structural Description

2020 ◽  
Author(s):  
Clemence BONNET ◽  
Louis Debillon ◽  
Saba Al-Hashimi ◽  
Florence Hoogewoud ◽  
Dominique Monnet ◽  
...  

Abstract Background: Anterior-segment optical coherence tomography (AS-OCT) is an important tool, helpful to diagnose and manage many corneal conditions, but has not been reported in cases of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS-OCT findingsin cases of PUK.Methods: Retrospective observational case series of six eyes with a PUK with proven systemic vasculitis. Clinical course, slit-lamp photographs, and AS-OCT findings were the main outcomes.Results: The AS-OCT findings were found to correlate with the ocular disease’s level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed.Conclusions: AS-OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.

2020 ◽  
Author(s):  
Clemence BONNET ◽  
Louis Debillon ◽  
Saba Al-Hashimi ◽  
Florence Hoogewoud ◽  
Dominique Monnet ◽  
...  

Abstract Background Anterior-segment optical coherence tomography (AS OCT) is an important tool, helpful to diagnose and manage many corneal conditions, but has not been reported in cases of peripheral ulcerative keratitis (PUK). The aim of this study is to describe AS OCT findings in cases of PUK. Methods Retrospective observational case series of six eyes with a PUK with proven systemic vasculitis. Clinical course, slit lamp photographs, and AS OCT findings were the main outcomes. Results The AS OCT findings were found to correlate with the ocular disease’s level of activity. In the acute stage, an absence of corneal epithelium, a scrambled appearance of the anterior stroma and a heterogeneous stromal reflectivity were observed. During the reduction of disease level activity, an irregular hyporeflective epithelium, a smoother anterior stroma, and a homogenous hyperreflective stroma were seen. At the healed stage, a filling of the corneal defect by a hyporeflective thick epithelium, the persistence of the hyperreflective underlying stroma, and a demarcation line were observed. The mean total corneal thickness at last follow-up was significantly thicker (509 ± 147 µm) compared with the mean corneal thickness at onset (408 ± 131 µm; P = 0.03). Conclusions AS OCT provides an assessment of structural changes occurring in PUK, useful for its diagnosis and monitoring.


2018 ◽  
Vol 2018 ◽  
pp. 1-4 ◽  
Author(s):  
Aakriti Garg ◽  
Joaquin De Rojas ◽  
Priya Mathews ◽  
Albert Hazan ◽  
James Lin ◽  
...  

We report two cases of peripheral ulcerative keratitis (PUK) imaged with anterior segment optical coherence tomography (AS-OCT). The first patient had prolonged nonsteroidal anti-inflammatory drug use, while the second had inflammatory arthritis by laboratory findings without any systemic findings as well as possible concurrent tuberculosis. In both patients, AS-OCT demonstrated corneal thinning at the onset of the disease with improvement six months after initiation of intensive medical therapy. Our cases highlight the need for a multidisciplinary approach and careful monitoring in PUK cases, especially with objective measures such as corneal thickness assessed with AS-OCT.


2015 ◽  
Vol 2015 ◽  
pp. 1-5 ◽  
Author(s):  
Mahmoud Mohamed Farouk ◽  
Takeshi Naito ◽  
Kayo Shinomiya ◽  
Hiroshi Eguchi ◽  
Khulood Mohammed Sayed ◽  
...  

Purpose. To evaluate the movement of the anterior and posterior lens poles during naturally stimulated accommodation in children using anterior segment optical coherence tomography (OCT).Methods. This is a prospective, observational, noncomparative case series including 18 eyes of nine children. Analysis of the anterior segment in the accommodated and unaccommodated state (with cycloplegia) was done using anterior segment OCT. The main outcome measures were the position of the anterior and posterior lens poles (in relation to the cornea) and lens thickness (LT).Results. A Statistically significant forward movement of the anterior lens pole and backward movement of the posterior lens pole with an increase in LT were found during accommodation (P<0.001). There was no significant difference between the degree of movement of the anterior lens pole and the posterior lens pole during accommodation (P=0.944).Conclusions. Anterior segment OCT provides a rapid noncontact method for studying accommodation in children. The backward movement of the posterior lens pole during accommodation nearly equals the forward movement of its anterior pole. These data minimize the theoretical hydraulic effect of the vitreous during accommodation, adding more support to the capsular theory of Helmholtz.


2017 ◽  
Vol 102 (6) ◽  
pp. 796-801 ◽  
Author(s):  
Akiko Narita ◽  
Yuki Morizane ◽  
Tomoe Miyake ◽  
Jiro Seguchi ◽  
Tetsuya Baba ◽  
...  

Background/aimsTo identify the cross-sectional characteristics of filtering blebs at 2 weeks post-trabeculectomy associated with intraocular pressure (IOP) control at 1 year post-trabeculectomy.MethodsNinety-nine eyes of 94 patients who had undergone primary trabeculectomy were included in this retrospective consecutive case series study. Surgical success was defined as an IOP ≤15 mm Hg and a >20% reduction in IOP without glaucoma medication or additional glaucoma surgeries at 1 year post-trabeculectomy. Subjects were classified into two groups according to whether surgery was successful or unsuccessful. Blebs were examined using swept-source three-dimensional anterior segment optical coherence tomography and evaluated for quantitative parameters, including maximum height, maximum wall thickness and ratio of hyporeflective space of the wall, as well as qualitative parameters, including multiple parallel hyporeflective layers within the wall (striping phenomenon), decreased visibility of the sclera underlying the bleb (shading phenomenon) and cyst-like structures of the wall.ResultsSeventy-seven eyes (77.8%) were assigned to the successful group and 22 (22.2%) to the unsuccessful group. Univariate analysis showed significant differences between the groups regarding maximum bleb height (p=0.044), maximum bleb wall thickness (p=0.017) and the striping phenomenon of the bleb wall (p=0.007). Multivariate logistic regression analysis confirmed that the striping phenomenon at 2 weeks post-trabeculectomy was significantly associated with success at 1 year post-trabeculectomy (OR 3.405; 95% CI 1.059 to 10.947; p=0.040).ConclusionTaller blebs with thicker walls that showed the striping phenomenon at 2 weeks post-trabeculectomy appeared to predict good IOP control at 1 year post-trabeculectomy.


2021 ◽  
pp. 30-32
Author(s):  
S.E. Avetisov ◽  
◽  
V.V. Strahov ◽  
Z.V. Surnina ◽  
A.A. Popova ◽  
...  

The most important tasks of preventing blindness and low vision in primary open-angle glaucoma (POAG) are its early diagnosis and quality monitoring in order to stabilize the glaucoma process. Purpose. To analyze the state of Langerhans inflammatory cells and the structure of corneal nerve fibers in patients with POAG. Material and methods. The study included 46 patients. The main group - 26 patients (52 eyes) aged 39 to 80 years - diagnosed with POAG stages I-IV. Control group - 20 patients (40 eyes) - ophthalmologically healthy volunteers with a normal level of intraocular pressure (IOP) and no signs of POAG at the age from 36 to 72 years. Patients underwent: visometry, biomicroscopy of the anterior segment of the eye, ophthalmoscopy, gonioscopy, contour tonometry using the Pascal method, optical coherence tomography (OCT) of the optic nerve discs (Zeiss Stratus 3000) and confocal microscopy of the cornea (CMR) (HRT III, Rostock Cornea Module). Results. In patients with POAG, according to CMR data, structural changes were revealed in the layer of nerve fibers of the cornea, and abnormalities in the structure and number of inflammatory macrophages (Langerhans cells) were also identified. The interocular asymmetry of CNF was investigated in patients with different stages of glaucoma in paired eyes. Conclusion. Аnalyzing the structure of corneal nerve fibers and Langerhans cells can be used as a diagnostic algorithm in patients with POAG. Key words: glaucoma, confocal microscopy, corneal nerve fibers, Langerhans cells, optical coherence tomography.


2017 ◽  
Vol 102 (4) ◽  
pp. 544-548 ◽  
Author(s):  
Guillermo Garcia-De la Rosa ◽  
Andrew Olivo-Payne ◽  
Juan Carlos Serna-Ojeda ◽  
Maria Sandra Salazar-Ramos ◽  
Alejandro Lichtinger ◽  
...  

ObjectiveTo assess anterior segment changes, including iridocorneal angle and vault, after toric and non-toric implantable collamer lens (ICL) V4c (STAAR Surgical AG) implantation under different lighting conditions.MethodsLongitudinal, prospective, case series. Patients with high myopia (>6 dioptres) underwent toric and non-toric ICL V4c implantation. Optical coherence tomography measurements were taken under different lighting conditions preoperatively and at 1 week and 1, 6 and 12 months of follow-up.ResultsSeventy-six eyes of 42 patients underwent ICL V4c implantation. Mean age was 27.4 years (±5.14 years, range 20 to 39 years). The average iridocorneal angle showed a statistically significant decrease (p<0.05) in all mesopic, scotopic and photopic conditions after 1 week of surgery compared with the preoperative measurements; in mesopic conditions, it decreased 14.1°, in photopic conditions 14.8° and scotopic conditions 13.2°. The angle measurement had a statistically significant change only in mesopic conditions (p=0.01) over the 1-year follow-up. The average vault under mesopic conditions was 0.661±0.21 mm at week 1. The vault measurement change was statistically significant over the 1-year follow-up in mesopic conditions (p=0.01). Refractive results showed a significant improvement in both uncorrected and corrected distance visual acuity (p<0.001).ConclusionThere is a significant reduction in the iridocorneal angle after ICL V4c implantation. Furthermore, there is a change under mesopic conditions in both the iridocorneal angle and vault during long-term follow-up.


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